Free Filing Fee - Rhode Island

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Office of the Secretary of State Corporations Division 148 W. River Street Providence, Rhode Island 02904-2615 (401) 222-3040

INSTRUCTIONS FOR FILING APPLICATION FOR CERTIFICATE OF WITHDRAWAL OF A FOREIGN BUSINESS CORPORATION
Section 7-1.2-1412 of the General Laws of Rhode Island, 1956, as amended The attached form is designed to meet minimal statutory filing requirements pursuant to the relevant statutory provision. This form and the information provided are not substitutes for the advice and services of an attorney and/or tax specialist. 1. A foreign corporation authorized to transact business in this state may withdraw from this state upon procuring from the secretary of state a certificate of withdrawal. In order to procure a certificate of withdrawal from the state of Rhode Island, a foreign corporation shall make application therefor by filing an Application for Certificate of Withdrawal (Form No. 154) with the Office of the Secretary of State, Corporations Division, at the above address. When the application is completed, signed, and submitted with the correct filing fee and letter of good standing noted in item 4 below, a Certificate of Withdrawal shall be issued. 2. The Application for Certificate of Withdrawal must be accompanied by a filing fee of $50.00, and payment should be made payable to the Rhode Island Secretary of State. 3. At the time of filing the Application, the corporation must be in good standing and current with the filing of its annual reports and the maintenance of its registered agent and its registered office in this state. 4. A letter of good standing from the Rhode Island Division of Taxation for the purpose of withdrawal must accompany the Application for Certificate of Withdrawal. The letter of good standing must be dated within thirty (30) days of the date of filing the Application for Certificate of Withdrawal. You may contact the Rhode Island Division of Taxation at One Capital Hill, Providence, RI 02903 (401) 574-8935. 5. The Application must be signed by an authorized officer of the corporation. If you have any questions, please call us at (401) 222-3040, Monday through Friday, between 8:30 a.m. and 4:30 p.m.

Instructions/Form 154 Revised: 04/08

Filing Fee: $50.00

ID Number:

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS
Office of the Secretary of State Corporations Division 148 W. River Street Providence, Rhode Island 02904-2615

BUSINESS CORPORATION ____________ APPLICATION FOR CERTIFICATE OF WITHDRAWAL
Pursuant to the provisions of Section 7-1.2-1412 of the General Laws of Rhode Island, 1956, as amended, the undersigned corporation hereby applies for a Certificate of Withdrawal from the State of Rhode Island, and for that purpose submits the following statement: 1. The name of the corporation is 2. It is incorporated under the laws of 3. It is not transacting business in the state of Rhode Island. 4. It hereby surrenders its authority to transact business in the state of Rhode Island. 5. It revokes the authority of its registered agent in this state to accept service of process, and consents that service of process in any action, suit, or proceeding based upon any cause of action arising in this state during the time the corporation was authorized to transact business in this state may subsequently be made on the corporation by service thereof on the Secretary of State of the State of Rhode Island. 6. The post office address to which the Secretary of State may mail a copy of any process against the corporation that is served on the Secretary of State: 7. As required by Section 7-1.2-1413 of the General Laws, the corporation has paid all fees and taxes. 8. If the corporation is in the hands of a receiver or trustee, this Application for Certificate of Withdrawal must be executed on behalf of the corporation by the receiver or trustee. 9. This Application for Certificate of Withdrawal shall be effective upon filing unless a specified date is provided which shall be no later than the 90th day after the date of this filing Under penalty of perjury, I declare and affirm that I have examined this Application for Certificate of Withdrawal, including any accompanying attachments, and that all statements contained herein are true and correct. Date: Signature of Authorized Officer of the Corporation Type or Print Name of Authorized Officer

Form No. 154 Revised: 12/05